Ereck Plancher trial: Doctor says sickle cell trait can't cause death

CaptionEreck Plancher trial

GEORGE SKENE, ORLANDO SENTINEL

UCF trainer Mary Vander Heiden testifies Thursday. She performed CPR on Ereck Plancher. Wrongful death suit against UCFAA in Orange County Court. Ereck Plancher died in 2008 during a football practice at the University of Central Florida.

UCF trainer Mary Vander Heiden testifies Thursday. She performed CPR on Ereck Plancher. Wrongful death suit against UCFAA in Orange County Court. Ereck Plancher died in 2008 during a football practice at the University of Central Florida. (GEORGE SKENE, ORLANDO SENTINEL)

Judge Robert Evans imposed a thousand dollar fine on two of the lawyers for UCFAA for speaking out of turn in the wrongful death suit against UCFAA in Orange County Court. Ereck Plancher died in 2008 during a football practice at the University of Central Florida.

Judge Robert Evans imposed a thousand dollar fine on two of the lawyers for UCFAA for speaking out of turn in the wrongful death suit against UCFAA in Orange County Court. Ereck Plancher died in 2008 during a football practice at the University of Central Florida. (GEORGE SKENE, ORLANDO SENTINEL)

Steinberg, an expert hired by the UCF Athletics Association, told the jury Wednesday afternoon there are no rigorous medical studies proving sickle cell trait can cause sudden death in athletes.

He went on to testify Orange County medical examiner Joshua Stephany's certified autopsy report stating Plancher died from complications of sickle cell trait was incorrect.

Plancher collapsed and died following offseason conditioning drills at the UCF football complex on March 18, 2008. Stephany told the jury last week extreme stress caused Plancher's red blood cells to sickle, or warp, and quickly damaged his major organs.

When Steinberg was asked for his opinion of National Athletic Trainers' Association guidelines for treating athletes with sickle cell trait, Steinberg responded, "generally, it's nonsense."

A task force of about 40 athletic trainers and physicians collaborated to write the NATA guidelines. The NCAA adopted similar guidelines.

When he was asked why UCF tested for sickle cell trait before Plancher's death, Steinberg responded, "They probably did it because the NCAA recommended it, but the NCAA's recommendation was ill founded."

During cross examination, Steinberg agreed it had more than 10 years since he had done a research on sickle cell trait. He added that he was more focused on sickle cell disease and had read literature on the subject of sickle cell trait.

Circuit Judge Robert M. Evans dismissed the jury at about 6:20 p.m. and informed them he planned to start the proceedings at 8:30 a.m. Thursday.

After the jury left the room, Evans gave the attorneys an update on the amount of time left for questioning witnesses, objections and closing arguments.

The judge reminded the attorneys that for months leading up to the trial, they stated it would take three weeks to the try case. Evans said the attorneys promised the jury they would only be serving for three weeks. After an especially combative first week, Evans gave the two sides an equal amount of time to present the remainder of their case.

Evans said the Plancher family attorneys have five minutes and 19 seconds remaining, while UCFAA attorneys have two hours and four minutes remaining.

The judge said he spent his lunch break reviewing appeal court decisions, paying special attention to the Fifth District Court of Appeals. He stated he risked the case being overturned on appeal if both sides were not allowed to present closing arguments, so he announced he planned to give them 60 additional minutes apiece solely for closing arguments. He said they could add any time they did not use to question witnesses for their closing arguments as long as it did not exceed 90 minutes.

UCFAA attorneys said the time limits altered the way they had already presented their witnesses and asked if the extra time could be cut to 30 minutes apiece. The judge denied the request.

He stated once the Plancher family attorneys' time is exhausted, they will only be allowed to raise objections. They will not be allowed to cross examine witnesses.

Evans expects to send give the jury instructions and send the group to deliberate midday Thursday.

He previously ruled the Plancher family attorneys would have to prove to a jury O'Leary ordered the water and athletic trainers be removed from the fieldhouse to earn punitive damages.

Before the jury considers punitive damages, it is scheduled to decide whether UCFAA is guilty of negligence for failing to do everything possible save Plancher's life.

If the jury decides UCFAA is guilty of negligence Thursday afternoon, the attorneys would present arguments Friday debating whether the Planchers are eligible for punitive damages. The jury then be sent back to deliberation.

UCF strength and conditioning coach Ed Ellis was among a long list of witnesses who testified Wednesday.

He told the jury Plancher participated in a strength and conditioning program designed to gradually get him into shape for spring practice that was scheduled to begin the day after the football player died. Ellis testified he had been informed before the March 18, 2008, workout that Plancher had sickle cell trait.

Ellis stated he never saw Plancher show any signs of distress during the workout. He also stated he never heard water or athletic trainers be removed from any workout he attended at UCF. He recalled asking assistant athletic trainer Robert Jackson, who Ellis stated was inside the fieldhouse, to check on Plancher after he showed difficult finishing jumping jacks at the end of the workout. Ellis testified Jackson moved toward Plancher immediately.

Ellis stated he saw a player trip during sideline-to-sideline sprints and later heard from others it was Plancher. Ellis said he was not concerned about seeing a player trip during sprints and running at three-quarter speed.

During cross examination, Ellis was asked if it would have alarmed him if he knew the unidentified player who tripped was Plancher because he had sickle cell trait. Ellis responded, "I would have looked at it more closely."

Jackson, the sole certified athletic trainer at Plancher's final workout, testified the football player did not show any signs of distress on March 18, 2008.

UCFAA attorneys played highlights of Jackson's videotaped deposition for the jury on Wednesday afternoon, the 13th day of the Plancher wrongful death trial.

Jackson stated while he did not know Plancher had sickle cell trait, knowing about the condition would not have changed how he treated the football player.

He stated that he followed National Athletic Trainers' Association and NCAA guidelines for treating someone with sickle cell trait by treating Plancher as though he was experiencing a medical emergency.

Jackson made conflicting statements about whether water was present in the fieldhouse during Plancher's last workout.

UCFAA attorney Dan Shapiro asked Jackson, "Would you agree with me that water bottles were inside the Nicholson Fieldhouse on March 18th, 2008?" Jackson responded, "Yes, sir, they were present. My hands were physically on them."

When Plancher family attorney J.D. Dowell reminded Jackson he stated in a report written on the day of Plancher's death that he needed to walk the football player outside "to get him some water and cool him down." Dowell then asked Jackson, "Did you not have water on you at that point?" Jackson responded, "On me, no, sir."

Jackson stated a large tub of water was located outside the fieldhouse. Dowell then asked Jackson, "do you recall any of those water bottles being inside the fieldhouse?" Jackson replied, "I don't know if they were inside or outside, but I know that they were there."

Before the jury took a lunch break, two doctors testified Plancher's death was caused by an undiagnosed heart condition.

Dr. Azorides R. Morales and Dr. Robert Myerburg, two experts hired by the UCF Athletics Association, told the jury the medical examiner's certified autopsy report stating Plancher died from complications of sickle cell trait was incorrect.

Myerburg, who has worked extensively as a cardiologist and is a University of Miami team doctor, also testified Plancher's final workout was not unusual and earlier treatment would not have saved his life.

Morales, who was chairman of the University of Miami pathology department for 34 years, told the jury Wednesday morning he examined slides of Plancher's cardiac conduction system -- a section of his heart. He showed the jury a magnified picture of the heart's sinus node artery.

He testified the slide showed fibromuscular dysplasia , or smooth muscle tissue and fibers, blocking the sinus node artery. He stated the node was "90 percent closed" and the heart wall "was too thick." He stated the block triggered a heart attack that caused Plancher's death.

"This is a condition that causes death," Morales told the jury on the 13th day of the Plancher wrongful death trial. "In my opinion, it caused the death of this gentleman."

Morales stated it was his opinion a portion of Plancher's heart was obstructed before his death.

"I don't know how long it was there because, this condition, we don't know what causes this particular condition and we don't know how long does it take to evolve into this condition," he said.

Stephany, the medical examiner, told the jury last week he stood by his findings that Plancher died from complications of sickle cell trait. Stephany and two Plancher family hired experts told the jury a heart condition could not have caused Plancher's death and the heart damage occurred after his death.

During cross examination, Morales agreed he has worked as a pathology professor and he does not work as a medical examiner certifying the cause of deaths.

Morales agreed when he was asked if the first time he gave sworn testimony about his opinion was June 10. He testified it was the first time he could recall studying a case involving sickle cell trait.

During his testimony last week, Stephany called study of the cardiac conduction system rare and a last resort for medical examiners when they can't find cause of death. He stated it was his understanding a cardiologist who was consulted for his final report wanted the system reviewed for research purposes.

Morales testified he could not answer "yes" or "no" if it was rare for medical examiners to study the conduction system, but he did say he teaches his students to do it for research purposes.

He was asked to draw what size the sinus node artery that was blocked would look like without magnification. Morales drew a dot that he stated should be "about two or three millimeters across." Morales testified the blockage of the sinus node artery was more important than the overall size of the artery.

Morales testified he defined sudden death as causing a person to die within an hour. When he was asked during cross examination how quickly a person would die if a 90 percent sinus node artery blockage had caused his death, Morales responded, "I don't know for sure."

Yerrid then asked, "If a person's heart is like a spark plug, if you take the spark plug out of the engine, how long will it continue to run." Morales responded, "I don't know for sure." He later added that the human body is very different from a car and he could not make a comparison of the conduction system of the heart to a spark plug.

Yerrid asked Morales whether other the other portions of the heart could have done the same job if the sinus node artery was blocked. Morales stated the atrioventricular node would take over. He later added 50 to 60 percent of the atrioventricular node was blocked as well.

Jenna Earls, a former UCF student athletic trainer who was the first witness called Wednesday morning, testified football coach George O'Leary never ordered water and athletic trainers be removed from Plancher's final workout on March 18, 2008.

She told the jury she was never ordered to leave the workout and she administered water to about four players when they asked for it during the workout. Earls testified it was her first day working at a student athletic trainer with the football program.

Her testimony conflicts with statements made by former UCF players Brian Watters, Anthony Davis and Cody Minnich, who testified O'Leary ordered athletic trainers and water be removed from the indoor practice facility on the day Plancher died.

O'Leary testified last week he never ordered the water and trainers be removed.

During cross examination, Earls was asked whether she knew Plancher tested positive for sickle cell trait before his death. She responded that she did not. She told the jury she recalled standing on the sidelines during the workout. Earls stated she could not recall UCF head football athletic trainer Mary Vander Heiden or former assistant athletic trainer Robert Jackson giving her any instructions on the day of Plancher's final workout.

Check back for live updates throughout the Plancher trial. Contact Iliana Limón at ilimon@tribune.com or 407-650-6353.